Friday, February 18, 2011

I once had a colleague who was a former Fleet Street journalist. I can't remember his name but I do remember a story he told over a particularly boozy dinner.

"The worst kinds of press releases," he said, "keep all the best bits for the end. That's just not how it should be done. It's like reading a news story that says 'A crowd gathered at Buckingham Palace today. There were also fire engines and ambulances. The corgies were brought out to safety. The Palace burned to the ground. The Queen is dead."

As I went on to work in communications, I kept that anecdote in mind and tried to make sure that the most important facts were kept in the lead of my news releases.

But this is not a news release and I can tell my story in way that pleases me.

I had an endoscopy yesterday.

I wasn't terribly worried when the secretary at reception couldn't find any record of me. I credit the Ativan for that. You still feel the anxiety but it's further away. Almost like it's someone else's anxiety.

She must have found me in the end, because I was called into the endoscopy unit, given an id bracelet and told to change into a robe.

The endoscopy unit at the Civic Hospital could use a facelift. The paint was peeling off the walls in the waiting room and the beds in the prep and recovery area are separated by curtains. My neighbour and I learned a lot about each others' medical histories and bowel movements.

The nurse who took my history and prepped me for the anesthetic noted my "crappy veins" but she got the vein accessed in one poke, so major kudos to her.

My bed was eventually wheeled into the room where the procedure would be done. At this point, I met Dr. A. for the first time. There was another doctor with him who introduced himself so quickly that I didn't catch his name. This second doctor, who I assume was a resident (why don't they introduce themselves as such? Residents always say, "I work with Dr. So and So." They never say "I am learning from Dr. So and So. Do they think the patients can't be trusted with this information? This really bugs me because I can always tell they are residents and I would be much more forgiving if they were honest with me) began to very rapidly list off all the horrendous risks of the procedure and then handed me a waver to sign.

It's a good thing that I had done tons of my own research (and that I had taken the Ativan) because I might have demanded that they wheel me out of there.

Dr. A. asked me if I had signed the waiver and if I had any questions. I said, "I just want to get this over with."

I mentioned my strong gag reflex to Dr. Resident. He instructed the nurse (pompously? Am I being biased?) to give me some extra shots of the anesthetic spray for my throat (I had the distinct impression that the nurse was going to do this anyway but perhaps I am biased). Then they hooked me up to the drip, placed a plastic frame with a hole in it in my mouth and shoved a tube down my throat.

I then proceeded to gag, choke and gasp for breath. Tears streamed down my face.

I'll never forget the nurse who gently held my head and spoke comfortingly to me.

It's amazing how big the endoscopy tube looked to me. There's no way it could have been that big in real life.

I heard Dr. A. say something about how studies had shown that the gag reflex was greatly diminished when Fentanyl is administered.

I heard Dr. Resident sound surprised.

A nurse administered Fentanyl via my IV. And then I was really, really stoned (I just read that Fentanyl is 100 times more potent than morphine and I had a cocktail with other sedatives).

Not sure if I passed out or not but I was pretty woozy. I know they called T. to come and get me. And I know that one of the nurses suggested I try and get dressed.

I sat up and nearly puked. The nurse got me to lie back down again.

Lather, rinse and repeat a few times.

One of the nurses gave me some apple juice, which helped.

I asked what drugs I had been given. A nurse looked that up and said with surprise that I had been given a drug in the Valium family and Fentanyl. She said, "No wonder you're so wasted."

I heard someone mention Gravol (known as Dramamine in the US). I now understand why they give it to me each time they give me Demerol at the cancer centre. They gave me a barf bag.

I texted T. to see why he still hadn't arrived. He texted back that he was in the waiting room. I told him to come get me. He said that the secretary wouldn't let him past the waiting room.

If he wasn't allowed past the waiting room and I wasn't allowed to leave without him (nor could I walk on my own), we were kind of stuck.

One of the nurses went to get him.

Before I left, Dr. A. came to talk to me. He said that I am to come to his office in around four weeks, at which time I will get my results. He also told me that there were no visible tumours (see what I mean about burying the good stuff under a whole pile of details?).

I went home and slept for 6 and a half hours. It would have been longer if T. hadn't come into the room to check on me. I was pretty dopey all evening (giving all my online Scrabble opponents an unfair advantage) and hit the hay before 10.

My throat hurts today and I'm still kind of tired but I did get out for a run (it's 10C here today that's 50F), so I guess I'm recovering pretty well.

In a months time, I'll find out if the biopsies revealed any pre-cancerous cells. Or if I have celiac disease. And Dr. A. promised that if they don't find anyting, he's going to want to do a colonoscopy.

Wednesday, February 16, 2011

I was late last week but I have been faithfully doing this. I'm down 5lbs since the beginning of the year. Not sure if there is any causal relationship or if this is due to my ongoing (ahem) gastrointestinal issues.

Week 2: Begin doing strength training exercises developed for cancer survivors. Work up to about thirty minutes, three times a week.

I got off track last week. It's hard to do core work when you have weasels chewing on your innards. I need to stop using this as an excuse not to work my arms and legs, though.

I've certainly been drinking more water, most days. I think half my weight may be an unrealistic goal, leaving me bloated and running to the loo all the time. I think I need to keep the goal but adjust the amount of water I'm expected to consume.

Week 5: Meditate every day. Start at five minutes and work my way up to twenty.

I have not meditated every day but I have at least half a dozen times in the last couple of weeks, which is around half a dozen times more than I ever have in my life. I still have to fight the monkey brain but I've worked my way up to 8 minutes. It's one way to make time slow down.

Week 6: I decided not to add anything to my plate.

Week 7: Always sit down to eat.

You'd think this would be no big deal but just a few minutes ago, I went to get myself a snack and caught myself eating sunflower seeds, while standing in the kitchen and thinking of wriitng this post. Clearly I need to work on mindful eating.

Friday, February 11, 2011

So I've been having some (ahem) gastrointestinal issues for a while. Last spring, I was diagnosed with GERD. Things got better after I made some amendments to my diet and started taking meds (so much better that I got lazy about the diet and just took the meds). But now the issues are back in spades, along with abdominal discomfort and a feeling I can only discribe as "weasels chewing on my innards."

A couple of weeks ago, I went to see my GP who doubled my dose of the meds, ordered some blood tests and other (ahem) samples and put in a referral to a gastroenterologist. She told me that it would likely be a six month wait.

I had chemo on Tuesday, February 1st, which means I should have been feeling more or less like myself on the week end. I did not. By Saturday, I was still achy, weak, nauseated and the stomach weasels were out in full force. On Sunday, I felt no better.

On Monday, I went back to my doctor.

She examined me and, to my enormous relief, reassured me that my liver is where it should be (not swollen and tender like it was when I was diagnosed with liver metastasis. She also said that I should take comfort from the fact that my blood counts, taken less than a week before had shown all my liver functions to be perfectly normal.

We discussed the possibility of me having contracted a parasite or a virus (I certainly know enough people who've been ill, including my two kids. My suppressed immune system - from the chemo - makes me susceptible to every passing illness) or that anxiety could be playing a role in my physical condition.

My doc is a great advocate, though, and she picked up the phone while I was still with her and left a message for the gastroenterologist, asking if I could be seen more quickly.

I left her office feeling almost euphoric, with all health related anxiety pushed to the back of my mind (there was enough other anxiety to take up all the space in the forefront).

Then yesterday, I got a call from my doc's office, telling me that I have an appointment with the gastroenterologist - and an endoscopy - scheduled for February 17. That's really soon.

I've heard that endoscopies can be really traumatic experiences, so I Googled "endoscopy" just to reassure myself (seriously, that's what I told myself).

Well, not only do I not feel reassured (they shove a camera down your throat to look at your innards! I have a very strong gag reflex) but I am now freaking out about the test and about exactly what it is they might find down there. It could be nothing. Could be something relatively benign. Or it could be...well I'm trying not to think about it.

I haven't been for a run in more than a week because of chemo and the (ahem) gastrointestinal issues. But I think I might risk it.

Thursday, February 03, 2011

My life is a work in progress (some days I feel like there has been more progress than others) and I can never quite escape the urge to make changes as the new year rolls in.

In the past I have I not found sweeping changes to be sustainable. Even my list of monthly changes last year didn't last past June.

However, my pledge to make soup was a huge success and has served me well. In fact, today's lunch was soup (kale, sweet potato and red lentil with home made turkey broth) I made and froze a couple of weeks ago. During a chemo week, when I don't feel much like eating anything, it's a real gift to have something easy to heat up and healthy to eat.

This year, I resolved that it would suit me best to make one new small change every week. And so far, this is working pretty well. I haven't been perfect but the changes are adding up and I do feel like new, healthful habits are being created.

So today, on the eve of the Chinese New Year, it seems fitting to come clean on the blog and go public with my changes. You can all help me stay accountable.

And do let me know if you have made any healthy changes so far in 2011. I realized the other day that I'm far from alone. Over at BlogHer they were talking about taking small steps to get healthy for the entire month of January. How'd I miss that?

Here are my changes so far:

Week 1: Weigh in and record my weight every Monday.

Week 2: Begin doing strength training exercises developed for cancer survivors. I've been doing these on run days and plan to work up to about thirty minutes, three times a week.

Week 3: Drink no more than five alcoholic drinks per week. I've gone over this limit every week so far but not by a lot.

Week 4: Drink more water. My nutrionist recommended drinking as many ounces as half my weight in pounds. This is a lot of water.

Week 5: Meditate every day. Start at five minutes and work my way up to twenty. This is something I have been meaning to do for a while. So far this week, I have meditated twice for ten minutes each time. It's a start.

Tuesday, February 01, 2011

Today is a chemo day, so I won't be around to post anything new. This piece originally appeared as a guest post on the blog of the Ottawa Regional Cancer Foundation. It's pretty Ottawa-specific but I suspect that many of the routines are similar, wherever you're being treated.

Further to yesterday's post, I thought I would write about what you can expect when visiting the cancer centre for a chemotherapy or other systemic treatment. When I was starting out, I found the chemo orientation and the tour to be very helpful but there was a lot of information to digest. And I was feeling so overwhelmed that much of it was quickly forgotten.

Checking in:

Present your green hospital card at reception and your requisition form for blood work, if you have an appointment to do that before chemo.

Blood work:

It's worth digressing at this point to talk about blood work. You need to have blood work done in advance of every chemotherapy treatment – usually the day before or the day of treatment. You don't need an appointment to go to the lab, just your requisition.

However, I highly recommend getting a picc or a port. I had a portacath put in after my second treatment (it's a pretty simple and quick procedure) and I have no regrets. Chemotherapy can cause veins to become hard and small and blood draws can become painful, frustrating and traumatic. By my second treatment, finding a working vein was already a challenge. I think that my port makes everything much easier and am always happy to show mine to other patients.

The only downside to going the port or picc route is that you have to make an appointment through the chemotherapy unit to have your blood drawn by a nurse. It's worth calling as soon as you know when your chemo will be. Allow about two hours between bloodworm and chemo. I always try and do both appointments on the same day – have my blood work done, then go have a snack and come back for chemo.

Back at reception:

Once you have checked in, look at your watch. Then go sit down in the waiting area and get comfortable (this is where a good book, crossword puzzle or knitting come in handy). You can also go and check out the free hats and scarves in the alcove to the right of reception. Just be sure and keep an ear open so that you know when you are being called.

If more than twenty minutes elapse between when you check in and when you are called, it's worth checking in again with reception to make sure there are no delays. In almost five years of treatment, I have only had to wait more than twenty minutes a handful of times.

The receptionist, a volunteer (in the yellow jackets) or a nurse will let you know when it's your turn and send you to one of the “pods” - the numbered units arranged around the outside perimeter of the unit.

Treatment:

Your nurse will introduce herself, go over your info (name other id, to make sure that you get the right drugs!) and you will be settled in a bed or a chair (don't be shy about stating your preference).

There are lots of chairs around for guests. If you have someone with you, ask them to sit on the opposite side from the iv drip, so that the nurse will have easier access and your friend will be more comfortable.

The nurse will take your “vitals” (blood pressure and temperature), check over your blood work and hook you up to the iv unit). Your drugs will be ordered from the pharmacy and while you wait, the nurse will likely start a saline drip, to get you hydrated.

Speaking of hydrated, it's perfectly OK to go to the bathroom during treatment. You're being filled with a lot of liquid! Just unplug your unit from the wall (they have batteries for back up) and head over to one of the washrooms.

I always bring my own blanket to chemo but there are also lovely warm sheets available to patients. Ask the nurse for one if you get cold.

During treatment you can read, talk to your friend, listen to music, watch a DVD and even cruise the internet (ask at reception for the wifi password). Do what you need to pass the time comfortably.

Treatment can take anywhere from ten minutes to several hours. When you're done, the iv unit will beep and the nurse will come and unhook you. She will mostly likely take your vitals again before sending you on your way.

I know that sounds like a lot of information but it's actually all pretty straightforward and there are lots of people there to ask for help and to answer questions. It will be easier than you think.

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about me

Laurie lives, writes and plays in beautiful Ottawa with her two gorgeous sons, one handsome spouse and an ill-behaved Tibetan Terrier. She enjoys strong coffee, knitting, reading, long walks around the neighbourhood and trying to find her floors under all the rubble (OK maybe not so much that last part). Laurie is the author of Not Done Yet: Living Through Breast Cancer and she also blogs at getfrivolous.com She dreams of one day writing a novel, travelling to Australia and finding matches for all the socks that come out of the laundry.